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Neck Pain and the Facet Joints

15 Jun

Neck pain is one of those conditions that virtually everyone has had at some point in time. The degree of how it can affect one’s life is highly variable—from minimal functional limitations to total disability. So where does neck pain come from and why are the “facet joints” so important?

The anatomy of a vertebrae in the spine is quite unique. There are seven vertebrae that make up the cervical spine. The top vertebra in the neck is called the atlas (C1), which basically swivels around the axis (C2). The atlas and axis allow us to rotate our head, such as when checking traffic or looking over our shoulder. The top two vertebrae (c1 and c2) are uniquely shaped, while the remaining cervical vertebrae (c3-7) are very similar in appearance with a vertebral body in the front and a bony ring with spinous process on the back that protects the spinal cord.

Between each vertebral body is a spinal disk and the processes are connected to the processes of the vertebrae above and below by facet joints.

The facet joints are a major source of neck pain, and injuries to the facet joints are commonly referred as “cervical facet syndrome.” Biomechanical studies show that the capsules that surround the facet joints have many nerve endings and can become highly strained when large amounts of force are applied to the body, such as during a motor vehicle collision.

When this occurs, the combination of inflammation and capsular deformation can lower the threshold in various pain producing receptors in the facet joint. This results in persistent neck pain which can increase with normal movement.

There are many treatment approaches available for persistent neck pain arising from the facet joints, such as spinal manipulation and joint mobilization performed by a doctor of chiropractic.

Home-based self-care recommendations may include specific exercises to stretch and strengthen the cervical spine, nutritional advice, home cervical traction units, a cervical pillow, and cervical curve-retaining techniques.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888 

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Chiropractic for Neck Pain?… Really?

15 May

There have been MANY studies conducted on the benefits and efficacy of spinal manipulation to treat back pain—so much so that many medical doctors frequently refer patients with back pain to chiropractors for this service. But what about neck pain?

Although it’s taken a little longer to compile the evidence, there is now substantial research to support that spinal manipulation for neck pain is equally effective as it is for low back pain in regards to improving pain levels, function, and quality of life.

Multiple reviews and meta-analyses (studies that evaluate the research over a series of years) indicate that mobilization, manipulation, and exercise all work alone but appear to give the best long-term benefits when used in combination with each other.

In the acute and subacute stages of neck pain, studies show cervical manipulation is more effective than various combinations of analgesics, muscle relaxants, and nonsteroidal anti-inflammatory drugs (NSAIDs) for improving pain and function in both the short and intermediate term.

Studies show that thoracic or mid-back manipulation is also very helpful for patients with neck pain. Chiropractic approaches often include a combination of spinal manipulation, manual cervical traction, figure-8 mobilization, and deep tissue trigger point/active release forms of therapy.

As noted above, the inclusion of exercise yields the best long-term benefits, especially for chronic neck pain.

One such exercise is Cranio-cervical flexion (deep neck flexor strengthening): Tuck the chin inwards, pushing the mid part of the neck backward with or without resisting into your fingers/hands or a towel wrapped around the neck. A gradual crescendo of pressure followed by a gradual release (or decrescendo) works well!

Another great exercise is Fiber Stretching: Side-bend the head and neck while applying gentle over-pressure while simultaneously reaching downward with the opposite arm/hand, searching for tight muscle fibers. Try combining forward and backward rotations and chin glide head movements while applying the over-pressure/reach combinations, and work each tight fiber until it loosens up.

There are many other exercises your doctor of chiropractic can show you, but these are a great start!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Where Does Your Neck Pain Come From?

16 Mar

Let’s first look at the anatomy of the neck in order to better understand the structures of the cervical spine that can generate pain.

Starting at the back of the spine, the facet joints allow us to move our neck and head in all directions, and each facet joint is surrounded by a joint capsule that is rich with nerve endings and when swollen, can generate pain both locally and radiating.

One study of volunteers with existing neck pain looked at the various pathways that pain travels when investigators injected each individual facet joint capsule with normal saline solution. Interestingly, the subjects felt pain in parts of the body other than just the neck.  For example, injecting the C6 facet joint capsule consistently reproduced radiating pain down the arm into the thumb side of the forearm and hand, similar to when a disk herniates and a nerve root is pinched. The primary difference was that a deep aching pain occurred in this area, as opposed to a more geographically well-defined pathway when a disk ruptures and pinches a specific nerve root.

The intervertebral disks are small shock absorbers that lie between each vertebral body. These disks are sort of like a jelly doughnut, which can sometimes leak out and pinch a nerve root producing pain (as well as numbness, tingling, and even weakness) that radiates along the course of the nerve.

Poor posture is perhaps one of the most common causes of neck pain. The muscles in the chest tend to be stronger than those in the upper back and pull the shoulders forward resulting in forward head carriage with protracted shoulders. For each inch of forward head shift, an additional ten pounds is added to the weight of the head, which already weights around ten to twelve pounds. Hence, a five-inch forward head carriage places an additional 50 pound load on the upper back and neck just to hold the head upright!

Doctors of chiropractic are trained to identify these faulty postures and track down the pain generator(s) when a patients presents with neck pain. Through patient education, spinal manipulation, mobilization, exercise training, modalities, and more, chiropractors can greatly help those struggling with neck pain!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

 

What Is Cervical Spondylosis?

16 Feb

Cervical spondylosis (CS) is another term for osteoarthritis (OA) of the neck. It is a common, age-related condition that you will probably develop if you live long enough. Or, if you suffered a neck injury as a youth, it can develop within five to ten years of the injury, depending on the severity.

It is basically caused by the “wear and tear” associated with normal daily living to which some refer to as “the natural history of degeneration.” According to the Mayo Clinic, CS or OA affects more than 85% of people over 60 years old, and that is probably a conservative estimate!

Common symptoms associated with CS/OA vary widely from no symptoms whatsoever to debilitating pain and stiffness. For example, when CS crowds the holes through which the nerves and/or spinal cord travel, it creates a condition called spinal stenosis that can result in numbness, tingling, and/or weakness. In severe cases, this can even affect bowel or bladder control (which is an EMERGENCY)!

CS occurs when the normal slippery, shiny cartilage surfaces of the joint(s) gradually thin and eventually wear away from excessive friction caused by years of repetitive use related to a job, sport, or just time. Bone spurs often form, which results from the body trying to stabilize an unstable joint. In some cases, the spurs can actually fuse a joint, which often helps reduce pain. (Bone spurs can also form if the intervertebral disks or shock-absorbing pads between the vertebrae are injured or become dehydrated due to arthritic conditions.)

Risk factors associated with CS include: aging, injury, years of heavy lift/carry job demands, and jobs and/or hobbies that require the neck to be outside of a neutral position (like years of pinching a phone between the ear and shoulder). Genetics and bad habits (like smoking) also play a role in CS. Obesity and inactivity also worsens the severity of CS symptoms.

The good news is that even though most of us will have CS, it is usually NOT a disabling condition. However, CS may interfere with our normal activities. Depending on its location, pain may feel worse in certain positions, like when sneezing or coughing or with movements like rotation or looking upwards.

Stiffness is a common symptom, which can vary with weather changes. Too little as well as too much activity can be a problem, but the BEST way to self-manage CS is to keep active! Range of motion exercises, strength training, and walking all help reduce the symptoms of CS.

Doctors of chiropractic are trained to identify CS/OA. Gentle manipulation, mobilization, nutritional counseling, exercise training, modalities (and more) can REALLY HELP!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Neck Pain and Sinusitis – What’s the Connection?

16 Jan

The connection between our sinuses and headaches is well established, but what about the relationship between neck pain and our sinuses? Is there a connection?

Sinusitis is very common in the spring when pollen counts are high and times when the cold and flu are rampant. It usually manifests with a clear runny nose and pain over the affected sinuses and other “histamine” related symptoms (watery eyes, sneezing, etc.).

The Mayo Clinic states at least two of four primary symptoms of chronic sinusitis (CS) need to be present to confirm a CS diagnosis: 1) thick, discolored nasal discharge or drainage down the back of the throat (post-nasal drip); 2) nasal obstruction due to congestion that interferes with nasal breathing; 3) pain, tenderness, and swelling in the eyes, face, nose, forehead; 4) a reduced sense of taste and smell in adults and a cough in children.

Other CS symptoms can include: 1) ear pain; 2) jaw or teeth pain; 3) cough—often worse at night; 4) sore throat; 5) bad breath (halitosis); 6) fatigue; 7) irritability; 8) nausea; and 9) neck pain. Acute sinusitis has similar signs and symptoms when compared with CS, but they are short-lived. Symptoms that warrant a primary care consideration include: 1) high fever; 2) severe headache; 3) mental confusion; 4) visual changes—double vision, blurriness, etc.; and 5) profound neck pain and stiffness.

Causation of CS include: 1) Nasal polyps; 2) deviated septum; or 3) other medical conditions (cystic fibrosis complications, gastroesophageal reflux or HIV and other autoimmune system-related diseases) that can block the nasal passage.

Risk factors for CS include: 1) nasal passage conditions (polyps, deviated septum); 2) asthma; 3) aspirin sensitivity (due to respiratory problems); 4) immune system disorder (HIV/AIDS or cystic fibrosis); 5) hay fever/allergies; 6) pollutant exposure (air pollution, cigarette smoke).

Complications of CS: 1) meningitis; 2) infection migration such as to the bones (osteomyelitis) or to the skin (cellulitis); 3) sense of smell loss (partial or complete “anosmia”); 4) vision problems (including blindness).

Many are not aware that neck pain and stiffness and jaw or teeth pain are symptoms of CS. Conditions like this are a reminder that it’s important for both the doctor and patient to be aware of ALL the symptoms present, even if they seem like they aren’t connected. While doctors of chiropractic are trained to look for non-mechanical causes for neck pain when a patient seeks care, it makes it easier if the patient is forthcoming with all their symptoms, even the ones that don’t seem relevant.

The good news is that doctors of chiropractic are trained to manage CS and can offer patients advice on lifestyle changes that may reduce the risk of the infection recurring. Furthermore, chiropractors often work with allied healthcare professionals when antibiotics or other measures are needed.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Head Tilt and Headaches – Are They Connected?

15 Dec

We’ve all seen people working on laptops in airports, airplanes, coffee shops, on the train, walking down the street…you name it! So how does this affect one’s neck, and does it contribute to headaches?

A 2016 study compared females with posture-induced headaches vs. healthy, age-matched female control subjects to see if there was any significant difference in their head-tilt and forward head position during laptop use.

The research team measured angles for maximum head protraction (chin-poking forwards), head-tilt, and forward head position at baseline (neutral resting) and while using a laptop. Essentially, they measured how “slumped” the participant’s posture was at rest vs. while working on a laptop.

The results showed that the headache group demonstrated an increased head protraction of 22.3% compared to the control group at rest. When comparing the ratio of forward head position during habitual sitting to the maximum head protraction, the researchers found a significant difference, which was also worse in the headache group. Similarly, laptop work head position was worse in the headache group.

The researchers concluded that the headache group showed worse posture at rest in the two measurements as well as more forward head posture during the laptop task than the control group. They recommended that management/therapy for patients with headaches and/or neck pain include posture retraining exercises as an important aspect of obtaining long-term successful outcomes.

This study illustrates the importance of that and the need to include exercises like chin-retractions, conscious head re-positioning, cervical traction (in some cases), deep neck flexor muscle strengthening, managing scapular stability, and more.

When looking at a person from the side, imagine a perpendicular line that passes through the ear canal should pass through the shoulder, hip, and ankle. In cases of forward head posture, that line will pass forwards of these bony landmarks.

Previous research shows that the head weighs an average of 12 pounds (5.44 kg), and for every inch of forward head positioning, the neck and upper back muscles are burdened with an extra 10 pounds (4.53 kg) of load to keep the head upright. That means a five-inch forward head position adds 50 pounds (22.67 kg) of weight to the neck and upper back area. It’s no wonder this faulty posture leads to chronic neck and headache complaints!

Spinal joint manipulation is one of the most patient-satisfying, fast-acting remedies for neck pain and headaches of several types offered by doctors of chiropractic. But when manipulation is combined with exercise training, studies show this combined approach results in the best long-term benefits or outcomes!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org